Communications

1
Communications
2
Communications

• Explore Go
• Learn and Practice Go
• Reflect Go
• Reinforce Go

3
Explore

• You will play a game that will highlight the
  importance of effective communication.

4
Communications

• Lessons Topic
• Overview Go
• 1 3 Communication Go
• 4 7 Interpersonal Communication Go
• 8 12 Communication Barriers Go
• 13 15 Patients Go
• 16 18 Documentation Go
• 19 21 Communication Technology Go

TABLE OF CONTENTS
5
Overview

• You will learn about
• Communication process
• Communication barriers
• Types of documentation

6
Fedor Ivanov

• Scenario
• Brought father to hospital
• English is a second language
• Hospital staff not communicating effectively

7
Questions

• What barriers prevented the hospital staff and
  Fedor from communicating?
• What could the hospital staff have done
  differently to communicate effectively with
  Fedor?
• What might happen if the hospital staff does not
  improve the way they communicate with Fedor?

8
Key Question

• Why is effective communication important in the
  health care industry?
• How do attitudes of respect and sensitivity
  affect communication?

9
Communication

• 1. Types of Communication Go
• 2. Communication Process Go
• 3. Quiz Go

10
Lesson 1 Communication in Health Care

• Process of exchanging messages
• health care workers
• patients
• patients families
• students and visitors
• administrators and business contacts.

11
Lesson 1 Verbal Communication

• Use of language and words
• Most effective form
• Goals
• Establish rapport
• Obtain information from patients
• Confirm understanding
• Relay information to other health care workers
• Give instructions to patients

12
Lesson 1 Tone of Voice

• Expresses speakers feelings
• Patients can pick up on fear, agitation,
  calmness, and confidence
• Adjust tone of voice appropriately to the
  situation

13
Lesson 1 Language Choice

• Translate medical terminology into lay terms
• At the same time, health care workers must avoid
  talking down to patients by over-simplifying
  their language.
• They should also be careful to enunciate words
  and avoid mumbling.

14
Lesson 1 Written Communication

• Form of verbal communication
• Allows writer time to research and to organize
  thoughts
• Must
• Be accurate and clear
• Be brief with logical organization
• Be free of grammar, spelling, and punctuation
  errors
• Use appropriate vocabulary

15
Lesson 1 Selecting the Correct Form

• Would message be better delivered orally?
• Does the message require a written record?
• What format?

16
Lesson 1 Writing Memos

• Often used in the health care industry
• Standard parts
• TO
• FROM
• DATE
• SUBJECT
• body

17
Lesson 1 The Five Ws

1. Who is the audience?
2. What is the purpose of the message?
3. Why is the message important?
4. When did or will the event occur?
5. Where did or will the event take place?

18
Lesson 1 Nonverbal Communication

• Used in addition to or as a substitute for
  language
• Includes
• Eye contact and facial expressions
• Gestures and body language
• Physical appearance
• Touch
• Proximity

19
Lesson 1 Eye Contact and Facial Expressions

• Direct eye contact sends a powerful and positive
  message
• Smiles and other facial expressions
• Be conscious of interpretation and own expression

20
Lesson 1 Gestures and Body Language

• People use their bodies instead of words
• Posture also conveys a message.
• Read and use gestures and body language

21
Lesson 1 Physical Appearance

• Uniforms send the message that they belong to the
  health care field
• Physical appearance is also expressed by grooming

22
Lesson 1 Touch

• Touch can communicate many things.
• Touch can also be misinterpreted
• Be conscientious to touch patients with only
  kindness and respect.

23
Lesson 1 Proximity

• Physical space between people
• Includes
• Distance between people
• Height
• Odor
• Sensitivity and professionalism are required when
  patient proximity is an issue

24
Lesson 2 Communication Process

• Communication is a process.
• The sender-receiver model is a way to break down
  the process into steps.
• Use with active listening

25
Lesson 2 Sender-Receiver Model

• The sender is the person who encodes, or gives,
  information.
• The receiver is the person who decodes, or
  accepts, the information.
• The message is the information that is being
  communicated.
• Other elements include frame of reference and
  feedback.

26
Lesson 2 Active Listening Skills

• Show interest.
• Be alert.
• Maintain eye contact.
• Avoid interrupting.
• Pay attention.
• Avoid thinking ahead for a response.
• Try to ignore personal prejudices.
• Ignore distractions by moving to a quiet place.
• Watch the speaker closely for nonverbal
  contradictions.
• Maintain a positive attitude.

27
Lesson 2 Restatement, Reflection, and
Clarification

• Restatement involves repeating the message back
  to the sender in the receivers own words.
• Reflection involves responding with empathy.
• Clarification occurs when the receiver asks
  questions to get a more concise explanation or to
  clear up any confusion about the message.

28
Lesson 2 Other Effective Communication Skills

• Be conscious of your own body language, including
  posture and eye contact.
• Avoid any display of anger.
• Speak slowly, softly, and clearly.

29
Lesson 3 Quiz

• In this lesson, you will take a quiz on types of
  communication and communication processes.

30
Interpersonal Communication

• 4. General Guidelines Go
• 5. Group Communication Go
• 6. Directions Go
• 7. Quiz Go

31
Lesson 4 Attitudes and Behaviors

• Adopt acceptable attitudes and behaviors
• Courtesy
• Respect
• Sensitivity to boundaries
• Empathy

32
Lesson 4 Courtesy

• Involves being polite, gracious, helpful, and
  considerate
• Overcome personal and other issues unrelated to
  the job

33
Lesson 4 Respect

• Approach another person with a feeling of esteem
  or regard
• Theme in any study of communication in health
  care
• Without proper respect, communication can quickly
  veer towards failure.

34
Lesson 4 Sensitivity to Boundaries

• Sensitivity is ability to see and appreciate the
  personal traits of others
• Sensitivity to boundaries is ability to recognize
  and observe the emotional and physical limits of
  others

35
Lesson 4 Empathy

• Ability to share in someone elses feelings or
  emotions
• Patients who are lonely or facing serious
  surgeries or terminal illnesses are in special
  need of empathy

36
Lesson 4 Diversity

• Put aside all personal and cultural bias
• Treat all people fairly, equally, and with
  sensitivity
• Be aware that others have cultural and personal
  biases

37
Lesson 4 Diversity (continued)

• Diversity includes the following
• Race
• Gender
• Age
• Ethnicity
• Socioeconomic status
• Occupation
• Health status
• Religion
• Sexual orientation

38
Lesson 4 Criticism

• Constructive criticism can build people up and
  inspire them to do better.
• Non-constructive criticism serves only to tear
  people down and discourage them.
• Be prepared to accept and give constructive
  criticism

39
Lesson 4 Accepting Constructive Criticism

• When people receive constructive criticism, they
  should appreciate it.
• People who receive criticism should avoid making
  excuses, getting angry, and blaming others.

40
Lesson 4 Giving Constructive Criticism

• When giving criticism, people should put
  themselves in the others place.
• Choose words carefully and speak kindly and
  considerately
• Allow the other person a moment to accept what is
  said

41
Lesson 5 Group Communication

• Health care workers must effectively communicate
  with their colleagues.
• Health care workers must put aside all personal
  prejudice and treat team members fairly and
  equally and so that they can communicate
  effectively in group situations.
• Successful group situations also involve an
  understanding of communication patterns,
  interaction, and participation.

42
Lesson 5 Communication Patterns

• Chain-of-communication pattern
• Wheel-of-communication pattern
• All-channel communication pattern

43
Lesson 5 Group Interaction

• Conformity occurs when individuals change their
  opinions or beliefs to match that of the group.
• In some instances, conformity can be bad, as it
  may cause people to go against their beliefs and
  values.
• In the professional world, conformity can be
  good. It is good when people conform to behave
  appropriately in the professional atmosphere.

44
Lesson 5 Group Participation

• Understand the group goals and own roles within
  the group
• In meeting situations, group members must
• Be prepared.
• Use active listening skills.
• Focus on the discussion.
• Share relevant ideas.
• Respect others.
• Follow through with assignments.

45
Lesson 6 Directions

• In the health care field, it is critical that
  directions are carried out correctly.
• In order for this to occur, directions must both
  be given and taken accurately.

46
Lesson 6 Giving Directions

• When giving directions
• Keep instructions simple and brief
• Give directions in a logical, chronological order
  
• Adjust language and complexity to the patients
  ability
• Have the patient restate
• Correct any misunderstanding

47
Lesson 6 Following Directions

• When following directions
• Be diligent
• Ask questions
• Take notes
• Follow through

48
Lesson 7 Quiz

• In this lesson, you will take a quiz on
  interpersonal communication.

49
Communication Barriers

• 8. Personal Barriers Go
• 9. Cultural Barriers Go
• 10. Physical Barriers Go
• 11. Environmental Barriers Go
• 12. Quiz Go

50
Lesson 8 Communication Barriers

• Many types of barriers
• A communication barrier
• make it difficult to send a clear message
• understand message being sent
• provide appropriate feedback.

51
Lesson 8 Personal Communication Barriers

• Can occur within either participant in
  communication
• Can result from emotions and attitudes,
  resistance to change, preconceptions, and
  self-absorption
• Can form out of prejudice and personality,
  including traits such as closed-mindedness,
  judging, belief in stereotypes, and preaching or
  moralizing

52
Lesson 8 Emotions and Attitudes

• Extreme emotions interfere with ability to
  concentrate
• Attitudes can create barriers. These attitudes
  may include
• Prejudice
• Selective comprehension
• Complacency

53
Lesson 8 Preconceptions

• Preconceptions are similar to prejudice.
• Typically directed toward to a single person,
  rather than a group
• Create barriers when people disregard what
  another is saying simply because they disagree or
  they do not care for the other person

54
Lesson 8 Resistance to Change

• Health care workers may have resistance
  themselves, or they may have to deal with a
  patients resistance.
• Be flexible and open-minded
• Communicate the benefits of change in a positive
  way to patients

55
Lesson 8 Self-Absorption

• When people are preoccupied, they can miss much
  of the message coming from another person
• Put own issues aside and focus 100 on their
  patients

56
Lesson 8 Overcoming Personal and Psychological
Communication Barriers

• Poor attitudes alienate patients
• Patients will attach little value to what is said
• Learn to overcome or put aside personal and
  psychological barriers

57
Lesson 9 Cultural Communication Barriers

• Values, beliefs, and customs that are common
  among a group of people
• Barriers include
• language
• health practices and beliefs
• eye contact
• religion

58
Lesson 9 Language

• Most obvious communication barrier
• Speak slowly and use simple words and gestures or
  pictures.
• Find an interpreter, if possible.

59
Lesson 9 Health Beliefs

• Beliefs about health practices and treatments may
  conflict
• Patient has the right to refuse treatment
• Be sensitive to these cultural conflicts
• Work with patients to make sure that they are
  getting the required care and treatment

60
Lesson 9 Eye Contact

• Differing cultural views on what is or is not
  appropriate eye contact can inhibit good
  communication.
• In some cultures direct eye contact is viewed as
  disrespectful.
• Respect and adjust to the patients cultural
  differences

61
Lesson 9 Religion

• Organized belief in a higher power
• Influence many aspects of peoples lives
  including birth, life, diet, illness, and death
• Be aware of common religious influences

62
Lesson 10 Physical Communication Barriers

• Patients who are physically or mentally impaired
  provide challenges when trying to communicate
  important health information.
• Physical challenges that can effect communication
  include
• Problems with hearing, vision, and speech
• Mental challenges
• Current physical and mental state

63
Lesson 10 Hearing Challenges

• Deaf patients
• Use sign language if possible.
• Utilize body language and gestures.
• Face the patient when speaking.
• Hard-of-hearing patients
• Face the patient when speaking.
• Speak clearly at a moderate pace.
• Keep sentences short and uncomplicated.

64
Lesson 10 Vision Challenges

• Blind patients
• Speak softly to them.
• Announce your presence.
• Describe procedures as they are happening.
• Explain unusual noises.
• Low-vision patients
• Volunteer to turn on more lights.
• Use bigger body gestures.

65
Lesson 10 Speech Challenges

• Aphasia
• Speech problems that originate with damage to the
  brain
• Patients may struggle both with speaking and with
  writing
• Health care workers must be patient and
  considerate by speaking clearly and simply.
• Dysarthria
• Trouble with particular sounds and slurring words
• Health care workers should be patient and
  encourage these patients to speak slowly and to
  use hand gestures.

66
Lesson 10 Physically or Mentally Challenged

• When interacting with a patient in a wheelchair,
  it is respectful for the health care worker to
  also be seated.
• Health care workers must also be sensitive to
  patients who are mentally or emotionally
  challenged. They must be prepared for anything
  and treat these patients with calmness, respect,
  and courtesy.

67
Lesson 10 Current Physical or Mental State

• Patients may not be able to communicate clearly
  if they are
• Very ill or in physical pain
• On strong medication
• Upset or confused
• Experiencing a great deal of stress
• Understand the context of the situation when
  interacting with patients.

68
Lesson 11 Environmental Communication Barriers

• Environmental barriers include
• Noise and activity levels
• Physical arrangement and comfort
• Time

69
Lesson 11 Noise and Activity Levels

• Control the noise and activity levels in common
  areas where patient-health care worker
  conversations might take place

70
Lesson 11 Physical Arrangement and Comfort

• Partitions and dividers
• Room temperature
• Make the physical arrangement welcoming and
  comfortable

71
Lesson 11 Time

• Communication barrier if not enough of it is
  devoted to interacting with a patient

72
Lesson 12 Quiz

• In this lesson, you will take a quiz on
  communication barriers.

73
Patients

• 13. Interaction Go
• 14. Education Go
• 15. Quiz Go

74
Lesson 13 Patient Interaction

• Feeling confident, comfortable, and competent
  during patient interaction takes practice and
  experience.
• Patient interaction involves several stages
• Preparation
• Introduction
• Assessment
• Treating and monitoring
• Feedback and follow-up

75
Lesson 13 Preparation

• Take a moment to prepare
• Review the patients chart
• Patients name
• Health history
• Chief complaint
• Special needs or precautions

76
Lesson 13 Introduction

• Enter the room calmly and formally introduce
  yourself.
• Name
• Position
• Purpose for being there
• Be positive and genuine

77
Lesson 13 Assessment

• Make observations and evaluate a patients
  condition
• Assessment includes the patients
• Appearance
• Personality
• Attitude
• Reaction to the health care worker
• Vital signs

78
Lesson 13 Treating and Monitoring

• Treating a patient involves reading and following
  a doctors orders.
• Describe the procedure in lay terms
• Monitor the patient, looking for any signs of
  change, good or bad

79
Lesson 13 Feedback and Follow-Up

• Assess the patient again.
• Ask patients how they are feeling.
• Take vital signs.
• Give patients feedback about the treatments.
• Let patients know how well they performed.
• Give pointers or tips about getting better
  results the next time.

80
Lesson 14 Patient Education

• One-on-one conversation or as a presentation to a
  group
• Patient education literature

81
Lesson 14 Patient Questions

• Patient questions often create patient education
  situations.
• Be prepared to answer these questions
• How did I get it?
• How long will it last?
• Am I going to die?
• Is it curable?
• Will I need medication? Will I need surgery?
• Will I be the same after I have recovered?

82
Lesson 14 One-on-One Conversation

• In one-on-one situations, health care workers
  must teach patients about treatments, procedures,
  therapy, and equipment.
• Make sure patients fully understand what is
  expected of them

83
Lesson 14 Group Presentation

• Health care workers may be required to deliver
  presentations for patient education purposes.
• To prepare, health care workers should ask the
  following questions
• Who is the audience?
• What is the audiences interest in the topic?
• Should the presentation be formal or informal?
• Are supporting materials necessary?
• What type of audiovisual will be most effective?

84
Lesson 15 Quiz

• In this lesson, you will take a quiz on patient
  interaction.

85
Documentation

• 16. Documentation Go
• 17. Reporting Go
• 18. Quiz Go

86
Lesson 16 Types of Documentation

• Many types of documentation and they vary from
  one agency to another
• Some standard documentation includes
• Health histories
• Notes
• Initial evaluations
• Progress reports
• Discharge reports

87
Lesson 16 Health Histories

• Provides the doctor with important information
  about the patient
• Health histories generally include
• General Statistical Data
• Chief Complaint
• Present Illness
• Review of Systems
• Past History
• Family History
• Personal/Sociocultural History

88
Lesson 16 SOAP Notes

• SOAP is an acronym for
• Subjective
• Objective
• Assessment
• Plan
• All employees know where to look for information
  and in what format they will find it
• Eliminate some excess writing and reading for
  health care workers

89
Lesson 16 Narrative Notes

• Tells the patients story
• Chronological order
• Can describe how a patients status, treatment,
  etc. has changed
• More time-consuming than the SOAP method.

90
Lesson 16 Initial Evaluation

• Groundwork for a patients file
• An initial evaluation includes
• Patient identification information
• Referral information reason, referral history,
  referral diagnosis, requested treatment,
  complicating factors
• Evaluation
• Diagnosis with rationale for treatment
• Treatment plan prescriptions, follow-up
  appointments, frequency and duration, goals

91
Lesson 16 Progress Report

• Contains information regarding a patients
  on-going care, treatment, and progress
• Occur over a specified length of time, which can
  be days, weeks, months, etc.
• Support and give evidence of the need for the
  patients continued medical care

92
Lesson 16 Progress Report (continued)

• Progress reports should contain the following
  information
• Patient information
• Current evaluation
• Diagnosis
• Treatment
• Assessment
• Complications
• Recommendations, changes, goals

93
Lesson 16 Discharge Report

• A discharge report has two functions
• It releases the patient back to their regular
  lifestyle, sometimes with some restrictions.
• It gives a record of the interactivity among
  health care providers, as it documents the
  patients success from the initial evaluation to
  release.

94
Lesson 16 Discharge Report (continued)

• Discharge reports should contain the following
  information
• Patient information
• Final evaluation
• Diagnosis
• Treatment
• Assessment
• Complications
• Recommendations and goals

95
Lesson 17 Documentation Guidelines

• Use a black ink pen.
• Write neatly and concisely
• Always include signature
• Correct errors appropriately.

96
Lesson 17 Documentation Guidelines (continued)

• Do not leave empty spaces
• Record items in chronological order.
• Only use abbreviations that are approved by the
  agency.
• Do not record information performed or observed
  by another health care worker.
• Destroy documents properly
• Double-check for the correct patient, chart, and
  form

97
Lesson 17 Fact versus Opinion

• Be careful to only include facts and to conceal
  own opinions
• Subjective and objective observations

98
Lesson 17 Subjective and Objective Observations

• Subjective observations are often called
  symptoms. They are not seen or felt. Instead,
  they are comments or complaints made by the
  patient.
• Objective observations are typically called
  signs. They can be measured or seen.

99
Lesson 17 Making Objective Observations

• Observe
• Sight - Unusual skin color, swelling, rashes,
  sores
• Smell - Body odor or unusual odors from the
  breath, urine, stools, or wounds
• Touch - Pulse and the condition of the skin,
  including temperature, swelling, and dryness or
  perspiration
• Sound - Respirations, coughing, and impaired or
  slurred speech

100
Lesson 17 Documenting Observations

• Both subjective and objective observations have a
  place in patient documentation.
• Objective observations should make up most of the
  report.
• Subjective statements made by the patient may
  also be included. However, they should be
  recorded in the patients exact words and
  quotation marks should surround them.

101
Lesson 17 Eliciting Information

• Know how to ask the right questions in order to
  get the information
• Ask broad questions that encourage patients to
  reply with more than yes or no answers.

102
Lesson 17 Confidentiality

• The information that goes into a patients file
  is confidential.
• Be sensitive to confidentiality
• Ask patients for personal information in a
  private environment.
• Be careful to close file folders before setting
  them down.

103
Lesson 18 Quiz

• In this lesson, you will take a quiz on
  documentation.

104
Communication Technology

• 19. Telephone Skills Go
• 20. Other Technology Go
• 21. Quiz Go

105
Lesson 19 Telephone Communication

• May be the first communication patients have with
  a health care agency
• Creates an impression

106
Lesson 19 Telephone Etiquette Greeting

• Good telephone etiquette includes a proper
  greeting.
• Identify yourself, the agency, and possibly the
  department

107
Lesson 19 Telephone Etiquette Voice

• Use a clear voice with a normal volume.
• Vary tone, pitch, and volume for emphasis
• Hold the phones mouthpiece about one inch from
  the mouth

108
Lesson 19 Telephone Etiquette Courtesy

• Be polite, gracious, helpful, and considerate
• Use the other persons name and say please and
  thank you.
• Be careful not to interrupt the other person

109
Lesson 19 Telephone Etiquette Attention

• Atmosphere around the telephone can be very busy
  and noisy
• Focus on the caller

110
Lesson 19 Taking Telephone Messages

• Phone messages should include
• The full name of the caller with the correct
  spelling
• The callers telephone number with the area code
  and extension number, if applicable
• The best time of day to return the call
• A brief message about the nature or purpose of
  the call
• The date and time the call was received
• A brief note of any action that was taken
• Their own initials in case there are any
  questions about the message

111
Lesson 19 Test Results and Triage

• The telephone should not be used to communicate
  bad news or complex information.
• The telephone is often used for triage.

112
Lesson 19 Answering Machines and Services

• Used to deliver a message to callers and record
  calls from patients.
• Answering services are more efficient in that the
  caller will be connected to an operator.

113
Lesson 20 Electronic Communication

• Automatic routing telephone systems (ARU)
• Paging systems
• Cellular phones
• Facsimile, or fax, machines
• Electronic mail.

114
Lesson 20 Automatic Routing Units

• Many telephone calls can be answered
  simultaneously
• Directions instruct the caller to press a number
  on the telephone key pad to reach a person or a
  department.

115
Lesson 20 Paging Systems

• Pagers beep and display either a telephone number
  or a digital text message.
• Pagers cannot be used for two-way communication.

116
Lesson 20 Cellular Phones

• Two-way communication tools
• Private patient information should never be
  discussed using cellular phones

117
Lesson 20 Fax Machines

• Used to quickly transmit data over telephone
  lines
• When using a fax machine
• Get patient permission before faxing records.
• Never fax financial information.
• Contact the receiver before and after sending a
  fax.
• Attach a cover sheet that contains a
  confidentiality statement.

118
Lesson 20 Electronic Mail

• Communication among health care workers,
  agencies, and insurance companies
• Often takes the place of printed interoffice
  communication
• Should never be used to communicate confidential
  patient information because e-mails can be
  intercepted

119
Lesson 21 Quiz

• In this lesson, you will take a quiz on
  communication technology.

120
Reflect

• Unit Questions Go
• Key Questions Go

121
Reflect Unit Questions

1. How can you apply active listening skills to your
   everyday life and the lives of those around you?
2. Compare and contrast subjective and objective
   information in reporting.
3. Your patient is very hard-of-hearing and speaking
   loudly does not seem to be working. What should
   you do?
4. Do you think that you have any personal barriers
   that would prevent you from communicating
   effectively with another person? If so, what can
   you do to overcome your own personal
   communication barriers?

122
Reflect Key Question

1. Why is effective communication important in the
   health care industry?
2. How do attitudes of respect and sensitivity
   affect communication?

123
Reinforce Project

• Communication Skit
• You will write and perform skits that demonstrate
  good and poor communication skills.

124
Reinforce Project

• Culture and Religion
• You will research and present information on a
  culture or religion, specifically its views on
  health care.

125
Reinforce Project

• Medical Records
• You will practice several filing techniques,
  including alphabetical, numerical, and
  categorical.

126
Reinforce Project

• Telephone Etiquette
• You will take a telephone message during a
  role-play exercise.